|Brief followup report: Does high-flexion total knee arthroplasty allow deep flexion safely in Asian patients?|
|PMID: 23054521 Owner: NLM Status: MEDLINE|
|BACKGROUND: The long-term survivorship of TKA in Asian countries is comparable to that in Western countries. High-flexion TKA designs were introduced to improve flexion after TKA. However, several studies suggest high-flexion designs are at greater risk of femoral component loosening compared with conventional TKA designs. We previously reported a revision rate of 21% at 11 to 45 months; this report is intended as a followup to that study.
QUESTIONS/PURPOSES: Do implant survival and function decrease with time and do high-flexion activities increase the risk of premature failure?
METHODS: We prospectively followed 72 Nexgen LPS-flex fixed TKAs in 47 patients implanted by a single surgeon between March 2003 and September 2004. We determined the probability of survival using revision as an end point and compared survival between those who could and those who could not perform high-flexion activities. Minimum followup was 0.9 years (median, 6.5 years; range, 0.9-8.6 years).
RESULTS: Twenty-five patients (33 knees) underwent revision for aseptic loosening of the femoral component at a mean of 4 years (range, 1-8 years). The probability of revision-free survival for aseptic loosening was 67% and 52% at 5 and 8 years, respectively. Eight-year cumulative survivorship was lower in patients capable of squatting, kneeling, or sitting crosslegged (31% compared with 78%). There were no differences in the pre- and postoperative mean Hospital for Special Surgery scores and maximum knee flexion degrees whether or not high-flexion activities could be achieved.
CONCLUSIONS: Overall midterm high-flexion TKA survival in our Asian cohort was lower than that of conventional and other high-flexion designs. This unusually high rate of femoral component loosening was associated with postoperative high-flexion activities.
|Hyuk-Soo Han; Seung-Baik Kang|
|Type: Journal Article|
|Title: Clinical orthopaedics and related research Volume: 471 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2013 May|
|Created Date: 2013-04-02 Completed Date: 2013-05-22 Revised Date: 2014-05-08|
Medline Journal Info:
|Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: United States|
|Languages: eng Pagination: 1492-7 Citation Subset: AIM; IM|
|APA/MLA Format Download EndNote Download BibTex|
Arthroplasty, Replacement, Knee* / adverse effects, instrumentation
Asian Continental Ancestry Group*
Knee Joint / physiopathology, radiography, surgery*
Life Style / ethnology
Range of Motion, Articular
Recovery of Function
Republic of Korea / epidemiology
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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